ABSTRACT
Maternal deaths over a 5-year period were reviewed retrospectively. The aim was to compare the incidence and causes of maternal deaths and the fetal outcome in women aged 35 years and above with women in the 20-24 age bracket. The classic triad of haemorrhage, sepsis and hypertensive disorders were the major causes of deaths in the 2 groups but were commoner amongst the elderly women. A higher incidence of perinatal mortality was also found in the elderly women's group compared to the younger women's group. Pregnancy and delivery at an advanced age is associated with increased risk and should be prevented by the use of effective contraception.
Subject(s)
Maternal Mortality , Obstetric Labor Complications/mortality , Pregnancy Complications/mortality , Adult , Female , Hemorrhage/mortality , Humans , Hypertension/mortality , Middle Aged , Nigeria , Parity , Postpartum Period , Pregnancy , Risk FactorsABSTRACT
A retrospective analysis was made of 27 maternal deaths after cesarean section occurring over a 5-year period. Sepsis was the single most important cause of maternal death (81.5%). The commonest indications for the cesarean sections were obstructed labor (59.3%) and cord prolapse (18.5%). The causes of maternal deaths were classified as avoidable and recommendations were made for their prevention.
PIP: A retrospective analysis of 27 maternal deaths associated with cesarean section and occurring at Nigeria's University of Ilorin Teaching Hospital in 1982-86 was performed. The cesarean section rate for the 48,974 deliveries that took place at the hospital during the study period was 4.1%. The death rate was 18.1/1000 cesarean sections compared with 1.89/1000 vaginal deliveries. Maternal sepsis was responsible for 22 (82%) of the cesarean section-associated maternal deaths; the remaining deaths were attributed to hemorrhage (1 primary and 3 secondary) and eclampsia (1 case). Obstructed labor was the single most important indicator for cesarean section (67%) and the most significant predisposing factor to maternal sepsis (63%). Most deaths from sepsis occurred on the 2nd-4th postoperative days. The skill of the surgeon was not a significant factor in maternal deaths. The most common antibiotic used to combat sepsis was a combination of ampicillin and gentamicin--a regimen that does not cover anaerobic organisms. Some patients did not receive antibiotics until the 3rd postoperative day because they were not on stock in the hospital pharmacy. Administrative difficulties, most notably inadequate laboratory backing and funding, also played some role in the high maternal death rate in this series.
